Heart valve regurgitation

[oxer]

hi, last year i had an echo for some sob and chest pain, i was told the echo was normal except fot some trace valve regurgitation in both the tricuspid and mitral valve. my pulmonary pressure was 16% and i was told the echo was normal. Its been a year and im still short of breath and have problems breathing normal, i have alot of trouble breathing and i get strong head pain around my ears. iam always dizzy and i also have feet pain. lately my back hurts right where the lungs are located on both the left and right side of my back. My question is would a normal echo like the one i had last year change in one year ? could it be that i need to repeat my echo. i had a stress echo 6 months back after asking my doctor and it was also normal. does a stress echo look for problems with the valves like regurgitation and pulmonary hypertension?  what is a stress echo good for in regards to pulmonary hypertension and valve regurgitation? thanks

[oxer]

Thank you doctor for answering my questions.

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

I am sorry to hear that you are struggling with all of these symptoms.  Although I am unlikely to be able to provide you with an exact diagnosis, I do anticipate I will be able to alleviate your concerns about pulmonary hypertension (PH).

Based on the information you have provided me, it is exceedingly unlikely that the symptoms you are experiencing are due to pulmonary hypertension.  In fact, it is almost certain that you do not have pulmonary hypertension at all.

“Trace” valvular regurgitation is entirely normal and nothing to worry about.  Also, though an otherwise normal echo can not entirely rule out the presence of PH, it is quite reassuring and makes it even more unlikely that your symptoms are cardiac in nature (or at least unlikely that you have PH of any significance).

A stress echo can be preformed for several reasons but the most common indication is to look for evidence of coronary artery disease (ie blockages in the vessels around your heart).  It is rarely used to diagnose PH and isn’t typically helpful to look for valvular regurgitation (and as I told you, trace valvular regurgitation is entirely normal).  A normal stress echo, which you had, is also quite reassuring in general.

Based on the information provided, I see no reason to repeat either your echo or your stress echo.  I do suggest, however, that you continue to see a good internist who can continue to investigate your symptoms and hopefully arrive at a diagnosis.

Wishing you all the best,

Dr. Rich.